Abstract
Introduction Ramadan involves sleep interruption (specifically during REM sleep),1 2 which could affect cognition and consequently have a negative effect on students during revision time and examinations. This study aimed to investigate the effect of sleep interruption on cognitive performance in students during Ramadan compared to normal sleep patterns.
Methods Participants were university students, recruited with ethical approval, who regularly (and during the study) had 7–9 hours total sleep. Following sleep interruption during Ramadan (30–90 mins at dawn), participants performed a Stroop test twice within an hour of awakening to assess processing speed and attention. Subsequently, the same test was performed after Ramadan with a maximum sleep interruption of 5 minutes. Participants’ time-differences between congruent and incongruent tasks, plus percentage accuracy, were compared between sleep interruption and normal sleep (baseline) for each participant, using Wilcoxon Signed Rank and T-tests
Results 70 students were recruited; 40 were excluded following an eligibility survey and 34 completed the study (15 males, 19 females). Stroop times were significantly slower during Ramadan, compared to minimal sleep interruption post-Ramadan [p<0.001] (figure 1). There was no significant difference in mean percentage accuracy between during and after Ramadan, in either sex [females p=0.11; males p=0.80] (figure 2).
A dot plot comparing the mean Stroop test scores during and after Ramadan for each participant, where an asterisk(*) denotes a significant difference where p<0.05
A bar graph comparing the difference in percentage accuracy during and after Ramadan in males and females
Discussion The main finding of this study was that sleep interruption due to Ramadan is associated with decreased speed of cognitive functioning, but not with a decrease in accuracy in students aged 18–25 years. These preliminary findings suggest that further research to investigate the effect of the effect of sleep interruption on memory and decision-making, which are key in exam-performance, would be of value. Other confounders such as hydration and chronotype should also be considered.
References
Bahammam Ahmed.Sleep pattern, daytime sleepiness, and eating habits during the month of Ramadan. Sleep and Hypnosis 2003;5:165–174.
Miyasita A, Fukuda K, Inugami M. Effects of sleep interruption on REM-NREM cycle in nocturnal human sleep. Electroencephalography and Clinical Neurophysiology ( 1989);[online] 73(2):107–116. Available at: https://doi.org/10.1016/0013-4694(89)90189-2
